...Boston MA (August 18 2011) In health care more choice may not alwa...In a new study researchers from Harvard Medical School's Department o... We are providing the most complex insurance choices to the very popul...The study will appear online August 18 in the journal Health Affair...

Boston, MA (August 18, 2011) In health care, more choice may not always lead to better choices, particularly for the elderly.

In a new study, researchers from Harvard Medical School's Department of Health Care Policy found that the large variety of managed care plans offered by the Medicare Advantage program may be counter-productive. Elderly patients, particularly those with low cognitive ability, often make poor decisionsor no decisions at allwhen faced with an overwhelming number of complex insurance choices. Ironically, those with impaired cognition may benefit most from the more generous coverage often offered by Medicare Advantage plans.

"We are providing the most complex insurance choices to the very population that is least equipped to make these high-stakes decisions," says J. Michael McWilliams, assistant professor of health care policy and medicine at Harvard Medical School and a practicing general internist in the Division of General Medicine at Brigham and Women's Hospital. "Most other Americans choose from just a few health plans, but elderly Medicare beneficiaries often have to sift through dozens of options."

The study will appear online August 18 in the journal Health Affairs. It will also appear in the September print edition of Health Affairs.

The Medicare Modernization Act of 2003 initiated a series of payment increases to the Medicare Advantage program. These payment hikes dramatically increased the number of private plans participating in the program and encouraged plans to compete for enrollees by offering lower premiums and more generous benefits, such as prescription drug coverage.

In order to examine the effects of these expanded choices and benefits of enrollment in Medicare Advantage versus traditional Medicare, McWilliams and his team looked at 21,815 enrollment decisions from 2004 to 2007 made by 6,672 participants in a national longitudinal survey, and compared enrollment de'/>"/>

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